title: Plasma versus serum levels of osteopontin and mesothelin in patients with malignant mesothelioma--which is best?
abstract: BACKGROUND
  Blood-based markers for malignant mesothelioma (MM), particularly soluble mesothelin and osteopontin, are currently of great clinical interest. As there is some concern about the sensitivity of osteopontin in serum versus plasma, we compared them in the same patient population to mesothelin.
  
  
  METHODS
  Soluble mesothelin and osteopontin concentrations were determined by commercial assays in blood samples from 66 patients with pleural MM, 47 patients with non-malignant asbestos-related lung or pleural disease, 42 patients with other benign pleural and lung diseases and 21 patients with lung cancer.
  
  
  RESULTS
  Soluble mesothelin and osteopontin in serum and plasma were significantly elevated in MM patients compared to patients with benign lung and pleural disease. At a level of specificity of 95% relative to patients with benign disease, the sensitivity of mesothelin in serum and plasma at presentation with symptoms was 67%, and for osteopontin in the plasma was 40% and in the serum was 20% for MM patients. Combining the serum mesothelin and plasma osteopontin markers using a logistic regression model did not significantly increase the area under the receiver operator curve.
  
  
  CONCLUSIONS
  Plasma osteopontin has a superior diagnostic accuracy to serum. As the choice of blood sample type has limit effect on soluble mesothelin sensitivity, plasma should be collected for biomarker evaluation in patients suspected of having mesothelioma.
authors.affiliation: National Research Centre for Asbestos Related Diseases, School of Medicine and Pharmacology, University of Western Australia, Sir Charles Gairdner Hospital, 4th Floor, G Block, Verdun St, Nedlands, WA 6009, Australia. creaneyj@cyllene.uwa.edu.au
authors.forename: Jenette
authors.initials: J
authors.lastname: Creaney
authors.forename: Deborah
authors.initials: D
authors.lastname: Yeoman
authors.forename: Arthur William
authors.initials: AW
authors.lastname: Musk
authors.forename: Nicholas
authors.initials: N
authors.lastname: de Klerk
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Skates
authors.forename: Bruce W S
authors.initials: BW
authors.lastname: Robinson
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood*; D001800:Blood Specimen Collection; D005260:Female; D058851:GPI-Linked Proteins / Q000097:blood*; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology; D008297:Male; D000090204:Mesothelin; D008654:Mesothelioma / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology; D008875:Middle Aged; D053495:Osteopontin / Q000097:blood*; D010949:Plasma / Q000378:metabolism; D011237:Predictive Value of Tests; D011379:Prognosis; D012680:Sensitivity and Specificity; D044967:Serum / Q000378:metabolism
chemical_list: D014408:Biomarkers, Tumor; D058851:GPI-Linked Proteins; D053495:Osteopontin; D000090204:Mesothelin